HomeMy WebLinkAbout1000-79.-2-8 a :3 TOWN OF SOUTHOLD
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�F
Rental Permit
0336
_ s
Owner Debra Farron
Occupied as Single Family Dwelling
Located at 5650 N Bayview Road Southold 79-2-8
Maximum Permitted Occupancy 9
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
8/12/2024
Code nW
nt Offici
This Notice must be posted by the main entrance at all times
o $Orlt
TOWN OF SOUTHOLD BUILDING DEPT.
631-765-1802
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG. -
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS: —6—wwe�.
OIL arz-
r
DATE �° �� a INSPECT-OR
Town Hall Annex
Town Of Southold 54375 Main Road
ra a Rental Inspection Report PO Box 1179
Southold, NY 11971-1179
Tel: 631-765-1802
Q
SUM# _ ' ,p�'' _ .., .. . .... .. Date . _.. .... ...g 1... .._
Owner / _. Phone
Address LjoM mPP {// Visible
. _ . _. .
Hamlet Inspector
` �_Floor Level Quantities Sub 1 2 3
Smoke Detectors ( bedrooms)
j
not located in bedr.. e,e .... ...�. �.,._ _.__ e.. r,l...�.��....... ....... �... _......,..�..� .. __ _,..._w ._..,..M.._.._
Caron„ Monoxide Detectors f
Fire onguishers.��.�.._. .� .�.. .... .m..�... . �m
_... .. a .._.�� . .. ..�. ... .�.. , _ .. ,. �� .. ..... �..... 1... ,_ .,, _ _..�.. .. ......
Exits
BeSmokesDetectors ......... 1 3 4 X
6 mµ .
.... ......_ ... ...... .. ✓�.... . w ..
_ ... .. .
� -",Egress",-"-
Occupant Count . .. ..._._._� _.. .__ ..... ... . ..+ ......
Building Systems Maintained &OperationalCondition of Property
.,
Heating n b_ ...._...�_�. �. ...w __..�_ ... �.. .. .. .. ., _.
Building interior
Hot water Building exterior
ElectricalProperty clean, maintained &safe
Mechanica.l...,.�. .... _._�.. .... .... .__.. .._� L..._.... Handrails& .�..�P... guards installed &secure�.�._...�......�., __. ...� .._.. .�a_._
e i
.mm .�_...�... e
Pool Safe .. Pool on Site
, ,. ..... .�. .. . �.... ..,... .. .. . .,.._... .
Surface water alarm Date of CO issuance
. _. ..._.....w .., ..... .
Door al . ._. .. ...���_
arms Pool completely enclosed
wow o requirements
Self closing/latching gates Pool fence to code
.. ... .. ........... ... ._. . .....
... ..�. .._.. .......
CO's for all items present
. .� .....
_.._.._.. ., _4Prior Rental... ...... . .... . .... .. ,.... ...
. . ......_.... . ... . .... __.._... �................._.. ry_.,_ .........._...
�omments
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TOWN OF SOUTHOLD
NCO
Rental Permit
� t
4
0336
Owner Debra Farron
Occupied as Single Family Dwelling
Located at 5650 N Bayview Road Southold 79-2-8
Maximum Permitted Occupancy 9
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
8/10/2022
Code Enfo nt Official
This Notice must be posted by the main entrance at all times
Town Hall Annex
SOUTHOLD TOWN 54375 Main Road
PO Box 1179 Southold,
too Rental Inspection NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
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" . .
TOWN OF S
Rental Permit
Permit No. 0336
Owner Debra Farron
Occupied as Single Family Dwelling
Located at 5650 N. Bayview Road Southold 79-2-8
Village S/B/L
Maximum Permitted Occupancy 9
: Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
9/16/2020 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
4,4- ,
0 so .
. ;
Town Hall Annex i Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLI)
RENTAL PERMIT APPLICATION (� � , i� ,r
Rental Permit Fee$200(Application must be renewed evetwo years)
AUG 3 0 2019
-E
Section A.
Property Information:
Rental Property
1�-c3
Tax Map Number: 1000 SECTION �� -BLOCK 9 -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name:
Property Owner Legal Address: Property Owner Mailing Address:
10 2-eO
Telephone Number(s): Daytime Evening Emergency (,o 3 3 ` (S.9,9
0
Property Owner Email Address:
v = 0
r 0
Page 1 of 5 40o
SOUTH®�a
Town Hall Annex , Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 Y Y4
Southold,NY 11971-0959
l�Crum
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
f
RENTAL PERMIT APPLICATION INSTRUCTIONS
Rental Permit Fee $200 (Application must be renewed every two years)
The items listed below are required to be submitted with the completed
application.
Ci Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of
all smoke &carbon monoxide detectors.
"Ce ificates of Occupancy and Pre-Certificates of Occupancy: Certificates of
occupancy or Pre-Certificates of Occupancy for each rental dwelling unit.
❑ Certification of Code Compliance(form enclosed): Must be submitted by a
license architect or engineer or license home inspector if an inspection by Town of
Southold Inspector is declined.
/Rental Permit Fee: $200.00
oF S° ,
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 9Z
Southold,NY 11971-0959 a Q
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name of Authorized Agent of dwelling unit, if any: sts
Address of Authorized Agent (no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
Section D.
Managing Agent Information:
Name of Authorized Agent of dwelling unit, if any:
Address of Authorized Agent(no P.O. Boxes):
Mailing Address of Authorized Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
SECTION E.
SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units)
Name of Managing Agent of dwelling unit, if any:
Address of Managing Agent (no P.O. Boxes):
Page 2 of 5
'c���� soUry��
Town Hall Annex Telephone(631)765-1802
54375 Main Road , Fax(631)765-9502
P.O.Box 1 179 5� �Q
Southold,NY 11971-0959 �c®U ,� �},��
BUILDING DEPARTMENT
TOWN OF SOgJTHOLD
Mailing Address of Managing Agent:
Telephone Number(s): Daytime Evening Emergency
Email Address:
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: \ o n(,)
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, Q the use of each room in the Rental Dwelling Unit
(for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier:
Requested Maximum number of persons allowed to occupy Dwelling Un t: 'co�
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit:
16
iy i y7 " 1✓f-� g x J L
`�►r' ✓� � `1 l� X ( 1 J
Page 3 of 5
139—
I�
/D
_sau��® '�,
Town Hall Annex �® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179 I
Southold,NY 11971-0959p!` c®U
a
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
SECTION G.
INSPECTION:
Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety
inspection by Code Enforcement Official is required. If the owner chooses not to have said
inspection performed by the Town, a certification from a licensed architect, a licensed
professional engineer or a home inspector who has a valid New York State Uniform Fire
Prevention Building Code Certification is required stating that the property which is the subject
of the rental permit application is in compliance with all of the provisions of the code of the
Town of Southold,the laws and sanitary and housing regulations of the County of Suffolk and
by the laws adopted by the New York State Fire Prevention and Building Code Council.
V11 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
❑ 1 am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
I certify under penalty of perjury,the following:
j
1. 1 am the owner of the property identified in "Section A"of this application.
2. The property owner's legal address set forth in "Section B" of this,application'is my legal
address and I understand the Town will use the address for service pursuant to all
Page 4 of 5
so
v
Town Hall Annex Telephone(631)765-1802
54375 Main Road ; Fax(631)765-9502
P.O.Box 1179 �, r
, eC
Southold,NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
Building Department of any changes of address within five (5) days of any changes
thereto.
3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and
agreed to abide by the same.
4. 1 will notify the Town within five (5) business days as to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name:—h ,�
Property Owner's Signature: IQ ,�
,� - ----�
Sworn to Pefore me this day of ..,
20 `7
K—°-1
Official Notary qublic Signature and Original Notary Stamp
Notary Pub"c,State of NDA M.RUDDER
w York
Quainf ed m gufr20932
olk County
Commission Expires March 8,20&D-)
Page 5 of 5
VORK NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y. L t'q'+
CERTIFICATE OF OCCUPANCY
No. .......a.1262....... Date ........ ... .......jr1knuary'..23........ 9.�.
THIS CERTIFIES that the building located
MapNo.**... .............. Block No. .."*... ....... Lot No ................. ...........................................
conforms substantially to the Application for Building Permit heretofore filed in this office dated
.•.. :1.1mir...2I%....................... .. 19.49, pursuant to which Building Permit No. $...931....
dated ... 19....S.S, was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is ..........
. ..... .. . i t •.• .. `+ •Ii••ti K98L�3i#...... .........................................................................
This certificate is issued to ............4.9hark-9. ..xCq--%My.A.APpj 4.. :r... c.r.? F ?yr..
(owner, lessee or tenant)
of the aforesaid building
...........
.........Building Inspect r...................... .
1
FORK NO. 1,
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. $0.0.07. . . . . . Date . . . . . . . . . . . .J ! . . . 8 . . . . ., 19.7.
THIS CERTIFIES that the building located at . . . W/S P• Road to BdTtitreet
Map No. . .9. . . . . . . . Block No. . . ? . . . . .Lot No. . . . . . So%tbold. . . . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office
dated . . . . . . . . . .July. . 1.7. ., 19- 14 pursuant to which Building Permit No. . . . ?
dated . . . . . . . . . . . July. . .18. ., 19- 14,4, was issued, and conforms to all of the require.
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is . . .bAY49 u91k:s9r7 _(Oprae
The certificate is issued to . . . .Rohert. XcCartby
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval N•8r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE No. . .K•RA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HOUSE NUMBER . . .5650. . . . . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Buil ' g Inspector
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold,N.Y.
Certificate Of Occupancy
Date . . . . .30,p.t YAtp,.V . 16. . . . .. . . .
THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .
Location of Property 5.63R. . . . . . . . . . .NQr h. o d ;o Bayview . . . . . . . . Southold. .
House No. S eei ' � Hamlet
County Tax Map No. 1000 Section .0 79. . . . . . . Bloch . .Q 2. . . . . . . . . . .Lot . . . . .0Q0. . . . . . .. .
Subdivision . . . . . .:C . . . . . . . . . ... . . . . . . . . . . . . .Filed Map No. . . . . . .Lot No. A . . . . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
19$?.pursuant to which Building Permit No. . 1.1,i 65. Z . . . . . . . . . . .
dated . . . . . 1113 . Q. . . . . . . . . . . . . . : 19 . ?,was issued,and conforms to all of the requirements
of the applicable provisions of the law.The occupancy for which this certificate is issued is . . . . . . . . .
.. . . . . . A .deck, .addi,tton, to.an existing. dwelling.. . . . . . . . . . . . . . . . . . .
The"certificate is issued to . . . . . . .Rohert. .J MQaa. A, &p.QElrtby. . . . . . . . . . . .. . . . . .
(owner,,/ease*,of*&m&ndl
of the aforesaid building.
Suffolk County Department of Health Approval . . . . . 11/a. . . . . . . . . . . . . . . . . .. .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . .nla. . . . . . . . . . . . . . . . . ... . .. . . . . . . . . . . .
of
. . . . . . . . . . . . . . . . . . . . . . . . . .
Building Inspector
Rev.IM
R
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
Certificate Of Occupancy
No. .2;1344.-2. . . . . . . . . Date . . . .. . . . . . .May.14. . . . . . . . . . . . . 19 85
THIS CERTIFIES that the building_..,�ccegsory, ,building , , , , , , , , , , , , , , , , , , , , , , ,
Location of Property .5,650, , . . . , , . , . .North Road to pp .i.ew Southold
House No, Street llamlei
County Tax Map No. 1000 Section . . . . . . .Block . . . . . .02. . . . . . .Lot . . 008, . . , . .
Subdivision . . . . . . . .X. . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . .Lot No. . . . , . . . . . . . .
conforms substantially to the Application for Building Permit heretofore filed in this office dated
. . .17axch. R . . . . . . . . 1984, pursuant to which Building Permit No. . '1.2923 .Z. , , , , , , , , ,
dated . . . . . .NaXo a.. .8 . . . . . . . . . . . . . 19$4. ,was issued, and conforms to all of the requirements
of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . .
. . . . . . axe_.acP-essDuy.bnilding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
The certificate is issued to . . . . ROBERT.McCARTHY
(owner,�tess�rt�nanrJ
of the aforesaid building.
Suffolk County Department of Health Approval . . . WE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . 11./.z'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
;t & a•.- 01-1
Building Inspector
Rev.1/81
M� S
rl OGT /
# 'x' TOWN 'OF SOUTHOLD BUILDING DEPT.
a
`ycvurm��'' 765-1802
-INSPECTION-
FOUNDATION
INSPECTION FOUNDATION 1ST [ ` ] ROUGH PL13G.
[ ] FOUNDATION 2ND= [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] INAL JJ��
[ ] FIREPLACE& CHIMNEY [ ` FIRE-SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION-
ELECTRICAL
ENETRATION-
ELECTRICAL- (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PRE C/O
REMARKS:
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!tA P.O.Box 1179
co 53095 Main Rd
�PIN�' Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 41447 Date: 9/16/2020
THIS CERTIFIES that the building WINDOWS
Location of Property: 5650 N Bayview Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 79.-2-8
Subdivision: Filed Map No. Lot No.
conforms substantially'to the Application for Building Permit heretofore filed in this office dated
8/31/2020 pursuant to which Building Permit No. 45199 dated 9/14/2020
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
"as built"window reolacement and electric service as applied for.
The certificate is issued to Farron,Debra
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45199 9/15/2020
PLUMBERS CERTIFICATION DATED
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